Rentea Rebecca M, St Peter Shawn D
Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
Pediatric Surgical Fellowship and Scholars Programs, Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
Surg Clin North Am. 2017 Feb;97(1):93-112. doi: 10.1016/j.suc.2016.08.009.
Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusively laparoscopic, with trials demonstrating better outcomes for children who undergo index hospitalization appendectomies when perforated. Nonoperative management has a role in the treatment of both uncomplicated and complicated appendicitis. This article discusses the workup and management, modes of treatment, and continued areas of controversy in pediatric appendicitis.
阑尾炎是儿童最常见的外科疾病之一。其症状可能表现为右下腹疼痛。评分系统结合选择性影像学检查和外科检查可诊断出大多数患阑尾炎的儿童。应采用临床路径。目前,大多数阑尾炎手术几乎都采用腹腔镜手术,有试验表明,对于穿孔性阑尾炎患儿,初次住院行阑尾切除术的效果更好。非手术治疗在单纯性和复杂性阑尾炎的治疗中均有作用。本文讨论了小儿阑尾炎的检查与处理、治疗方式以及仍存在争议的领域。